Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.

  title={Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.},
  author={Richard P. Mattick and Courtney L Breen and Jo Kimber and Marina Davoli},
  journal={The Cochrane database of systematic reviews},
BACKGROUND Buprenorphine maintenance treatment has been evaluated in randomised controlled trials against placebo medication, and separately as an alternative to methadone for management of opioid dependence. OBJECTIVES To evaluate buprenorphine maintenance compared to placebo and to methadone maintenance in the management of opioid dependence, including its ability to retain people in treatment, suppress illicit drug use, reduce criminal activity, and mortality. SEARCH METHODS We searched… 

Buprenorphine for managing opioid withdrawal.

Buprenorphine was associated with a lower average withdrawal score (indicating less severe withdrawal) during the treatment episode, with an effect size that is considered to be small to moderate, compared to clonidine or lofexidine.

Slow-release oral morphine as maintenance therapy for opioid dependence.

The present review did not identify sufficient evidence to assess the effectiveness of SROM for opioid maintenance because only three studies meeting the inclusion criteria have been identified.

Maintenance treatments for opiate -dependent adolescents.

There is an urgent need for further randomised controlled trials comparing maintenance treatment with detoxification treatment or psychosocial treatment alone before carrying out studies that compare different pharmacological maintenance treatments.

Medication-AssistedTreatmentWith Buprenorphine:AssessingtheEvidence

BMT is associated with improved outcomes compared with placebo for individuals and pregnant women with opioid use disorders and should be considered for inclusion as a covered benefit, according to available research.

Pharmacological therapies for maintenance treatments of opium dependence.

To evaluate the effectiveness and safety of various pharmacological therapies on maintenance of opium dependence compared to no intervention, detoxification, different doses of the same intervention, other pharmacologic interventions and any psychosocial interventions, a systematic review of the literature is lacking.

Comparative effectiveness of buprenorphine-naloxone versus methadone for treatment of opioid use disorder: a population-based observational study protocol in British Columbia, Canada

The effectiveness of buprenorphine/naloxone vs methadone will be determined using intention-to-treat and per-protocol analyses—the former emulating flexible-dose trials and the latter focusing on the comparison of the two medication regimens offered at the optimal dose.

Opioid agonist treatment for people who are dependent on pharmaceutical opioids.

The effects of maintenance opioid agonist pharmacotherapy for the treatment of pharmaceutical opioid dependence is assessed and low-certainty evidence from four studies favouring maintenance buprenorphine treatment over non-opioid treatments in terms of fewer opioid positive urine drug tests at end of treatment is found.

Dihydrocodeine for detoxification and maintenance treatment in individuals with opiate use disorders.

Low-quality evidence is found that DHC may be no more effective than other commonly used pharmacological interventions in reducing illicit opiate use and other health-related outcomes among adults compared to other drugs or placebos used for detoxification or substitution therapy.

Buprenorphine treatment of opioid dependence: analysis of individual patient data

In a large cohort of trial participants treated with buprenorphine and behavioral counseling for opioid dependence, four novel treatment factors reflecting components of bupenorphine dose, clinical provider engagement and patient engagement are identified and ranked.

Effect of Buprenorphine Dose on Treatment Outcome

Strong evidence exists based on 21 randomized clinical trials that the higher buprenorphine dose may improve retention in bupRenorphine maintenance treatment.



Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence.

Methadone is an effective maintenance therapy intervention for the treatment of heroin dependence as it retains patients in treatment and decreases heroin use better than treatments that do not utilise opioid replacement therapy, and does not show a statistically significant superior effect on criminal activity.

Buprenorphine versus methadone maintenance for the treatment of opioid dependence

A controlled trial comparing buprenorphine and methadone maintenance in opioid dependence.

Buprenorphine maintenance at 8 mg/d appears to be less than optimally efficacious under the conditions of the present study, and continued research is needed to reconcile these findings with the more positive results reported by other investigative groups.

A controlled trial of buprenorphine treatment for opioid dependence.

Buprenorphine was as effective as methadone, 60 mg/d, and both were superior to methad one, 20 mg/D, in reducing illicit opioid use and maintaining patients in treatment for 25 weeks.

Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation.

Flexible dosing of MMT and BMT appears to be similarly effective whether delivered in a primary care or outpatient clinic setting, and in a direct comparison, MMT was found to be slightly more effective and less costly than BMT.

Buprenorphine vs methadone maintenance treatment for concurrent opioid dependence and cocaine abuse.

The results support the superiority of higher daily buprenorphine and methadone maintenance doses vs lower doses for reducing illicit opioid use, but the results do not support the superior of bupenorphine compared with methamphetamineadone for reducing cocaine use.

Methadone maintenance at different dosages for opioid dependence.

Methadone dosages ranging from 60 to 100 mg/day are more effective than lower dosages in retaining patients and in reducing use of heroin and cocaine during treatment.

Buprenorphine implants for treatment of opioid dependence: a randomized controlled trial.

Among persons with opioid dependence, the use of buprenorphine implants compared with placebo resulted in less opioid use over 16 weeks as assessed by urine samples and a greater change on clinician global ratings of severity of opioid dependence.

A randomised trial of the cost effectiveness of buprenorphine as an alternative to methadone maintenance treatment for heroin dependence in a primary care setting

Although some of the results suggest that methadone may have a cost advantage, it is difficult to infer from the trial data that offering buprenorphine as an alternative would have a significant effect on total costs or outcomes.

Buprenorphine maintenance treatment of opiate dependence: a multicenter, randomized clinical trial.

It is suggested that an adequate dose of buprenorphine will be a useful addition to pharmacotherapy and safety outcome measures provided by clinical monitoring and by analysis of the reported adverse events.